clear airway events

Last night was night three using the cpap
My AHI was 4.42 but I had a total of 22 clear airway events

Please tell me what a clear airway event is and are these numbers good, bad, worrisome at day three
I still wake up feeling like I need a few more hours of sleep. How long does it take to start feeling rested?

Date Sleep Wake Hours
8/25/2012 20:14 04:11 07:55:04
AHIApnea / Hypopnea Index 4.42
HypopneaHypopnea 0.13
ApneaUnspecified Apnea 0.00
ObstructiveObstructive Apnea 1.52
Clear AirwayClear Airway Apnea 2.78

clear airway events -22 over the night

Clear airway or central.... A respiratory episode where there is no airflow and no effort to breathe lasting greater than 10 seconds. The airway is open but no air is moving. CPAP pressure doesn't fix this type of apnea event because the airway is already open and cpap pressures sole job is to hold the airway open.

Obstructive apnea or hyponea where the airway tissues have either fully collapsed or partially collapsed and the tissues themselves are blocking the airway so the reduction in flow is because of the physical presences of the collasped tissue in the airway. CPAP pressures help hold the airway open to hopefully prevent the tissues from collapsing so much or so often.

Your numbers are fine. It is better to see the detail graphs than just the numbers. We can't see the overall pattern to the events...when did they happen...most of them maybe at sleep onset or whatever.
So unless I can see the detailed graph about all I can say is that each number is well within acceptable range..
The bulk of your AHI is clear airway events and we don't do anything about them unless they are in much greater numbers than what you are seeing. I suspect a good many of those are probably being flagged while awake or semi awake and wouldn't even be flagged in a sleep lab setting.

How long does it take to feel better? Well some people get lucky and feel better immediately but most of us it takes considerable time. There is no hard fast answer as to when or if you will feel better.
3 nights on the machine....way too soon to expect to see much of a change for the majority of people.
So it takes as long as it takes...there is no time frame...most of the time the changes are very gradual and hard to see until you maybe look back over 30 or 60 days.

Also, people tend to put all their "I don't feel so great" eggs in the OSA basket and expect the cpap machine to fix everything...not everything is related to OSA and the cpap machine only fixes stuff related to OSA.

Thank you for your response. When the sleep doctor went over my results, she did not mention central apneas. The report didn't mention central apneas either. I would hope that the doctor or report would have mentioned them if the were a problem


I took a screen shot of the graphs and am able to save them to a word document but am unable to paste it to this board. What am I doing wrong?

The centrals are probably not a problem.

Here's the thing...the machine doesn't know if you are awake or not and doesn't know what sleep stage you are in.
All it knows to do is flag air flow movement or lack of. It can and will flag open airway cessation of breathing as a central (clear airway) event. It is common to have "centrals" during sleep stage transition especially sleep onset.
It is common to maybe hold your breath when you turn over in bed...but that pause in breathing might get flagged as a "central". It is extremely common for the machine to identify irregularities in breathing while awake as some sort of event. All of these wouldn't be flagged in a sleep lab study as a true central because they can tell if you were asleep or not or turning over in bed...the machines we have at home can't tell...so they just call them like they see them.

People tend to see "centrals" and go into panic mode and it is not warranted. Even a few "true centrals" would be normal. Some of yours may be "true centrals" and some of them are likely awake/semi awake centrals and sleep stage transition centrals. If you are seeing some real close to when you turn the machine on or right before you turn the machine off then you can probably discount those as not being "true central".
If you spend lots of time laying there in bed with the machine on then you likely have some awake breathing irregularities being flagged.

Since in some situations the centrals are normal...and in some situation we have "centrals" get flagged that we can't tell for sure if they are real or not we sort of have to just shrug our shoulders unless the numbers that we see are excessive. Yours isn't excessive. Even if every one of what you see being flagged was a "true centrals" and would be flagged as such in a sleep lab, you don't have enough of them that the doctors would worry about them.

You are new to the machine. Probably some awake time on the machine because it takes a while to get adjusted to this thing being stuck on our face. So I am pretty sure you have some of those being flagged.
As you use the machine more and get more adjusted to sleeping with the mask on your face and get better quality sleep...I expect that you will see the "centrals" drop in number. They won't ever totally go away...we all can have a few...but you will find that some nights you might have none, some nights maybe a handful and some nights you will have more than a handful. I have been on the machine over 3 years now. Some nights I have no centrals, some nights maybe only one or two and some nights it looks like I had a central convention. Most often when I know that I was likely awake but not long ago I had 17 centrals in 17 minutes...don't remember being awake but maybe I was.. Looked real impressive on the graphs though. It was a fluke...I don't know what the deal was. Never had that happen before...so I shrug my shoulders and laugh and blame it on aliens. Sometimes we don't have answers to everything.

When evaluating your AHI...we like to see it less than 5...and you have to sort of mentally remove the central (clear airway) index because we don't treat that part with pressure anyway.
When we remove the CA index...the remaining index is well below 5 and very acceptable...so good numbers.
Heck, even with your CA index included...you are below 5 AHI...good numbers.

So your numbers look good and I don't see anything that needs improvement.
Leaks are always a battle and so is hours of sleep...But nothing on your reports now as shown shouts out that it needs urgent fixing.

You just need time and experience on the machine...concentrate on quality of sleep and not the numbers.
If your sleep is fragmented...try to figure out why. Any insomnia issues? Meds? Aches and Pains? Stuff along those lines. There's a whole lot more to feeling good than an AHI number. I wish that was all it took but unfortunately often we have other things that mess with sleep quality that the AHI can't fix.

Thank you for the info

I DID IT. I FIGURED OUT HOW TO INSERT MY CHARTS

You can hide the AHI graph (you have the top events graph which is more important) and you can hide the mask pressure graphs as it just reflects the pressure graph.
Go to the Preferences in top left under "File"...then go to the "graphs" tab and remove the check mark from the graphs that are really unneeded and in the way. This allows the lower graph like leak line to move into viewing area so easier to get a single screen shot that includes pretty much all you really need to watch at this stage of things.
You can also resize the vertical height of the graphs so that you can get another graph to move into viewing area.
Just take your mouse cursor and hover on the bottom line of the graph until you see a short double line thing..click and drag the bottom line up just a bit and the graph box isn't so tall.
SleepyHead remembers the change so you only have to do it once.
Make sure if you have clear airways flagged that the top of the events flag shows them.

This is how mine looks after I played with it. I don't need to see the other stuff all the time and if I do I just go and turn those graphs back on. This happens to be the night that I figure the aliens came to visit me. 17 centrals flagged during 17 minutes..right about 6:00AM I don't remember being awake but I might have. This is the first time I have ever had something this remarkable show up and I couldn't explain it. I have had some nights where I know I was awake..stomach bug but nothing like this. If this were a common occurrence then yes I would worry but it isn't.
I do seem to remember waking briefly from a dream where my back hurt (I do dream that dream often) and of course my back hurt pretty bad so I change position in bed and go back to sleep. This may have been when that happened. I may have just had some real bad back pain and have it mess with my breathing.
Anyway, this is mainly what I look at. I have turned off the unneeded graphs and did a bit of resizing so now when I do a screen shot I get the important stuff all in one picture.

You're in good hands with Pugsy, but I notice your pressure is pretty high. High pressure can cause centrals to occur, through a reflex that I won't bore you with the name of. Talk to your sleep doc about the clear airway apneas, and ask her whether the pressure could be causing them, or whether you naturally tend to have them, and she didn't tell you that.

I have an appointment with the sleep doctor in two weeks to review everythiing. I will ask her then.